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Flashcards in fibromyalgia Deck (12)
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1
Q

characteristics of fibromyalgia?

A

Pain is distinctly different from nociceptive pain

Disengaged from noxious stimuli or healing

Widespread musculoskeletal pain with no cause identified

2
Q

pathophys of fibromyalgia

A

Central Sensitization or Centralized Pain:

  • Characterized by disturbance in CNS pain processing
  • Responsive to neuroactive compounds altering levels of neurotransmitters involved in pain transmission
3
Q

Non-pharmacological treatments

A
Patient education
Graded exercise
CBT (OT or Psych)
CAM
CNS neurostimulatory therapies
4
Q

Pharmacotherapy for FM

A
Amitriptyline
Cyclobenzaprine
Duloxetine (Cymbalta)
Milnacipran (Savella)
Gabapentin
Pregabalin (Lyrica)

minority of patients experienced substantial improvement

Moderate degrees of benefit were seen in pain and sleep

5
Q

MOA for TCA’s (amitriptyline and desipramine)?

A

TCA-blockade of NET and SERT channels

initial dose 10mg QHS, usual final 25-50mg

6
Q

ADE’s for TCA’s (amitriptyline and desipramine)?

A

dry mouth, constipation, fluid retention, weight gain, grogginess, difficulty concentrating are common

side effects and possible cardiotoxicity limit use in older patients

7
Q

MOA for cyclobenzaprine?

A

Centrally acting skeletal muscle relaxant pharmacologically related to TCAs

8
Q

indications for cyclobenzaprine?

A

Mild to moderate symptoms

Minimal antidepressant effect

9
Q

ADE’s for cyclobenzaprine?

A

Drowsiness, xerostomia, change in mental acuity, constipation, neuromuscular and skeletal weakness, blurred vision

10
Q

MOA for Duloxetine and Milnacipran

A

SNRI

11
Q

Uses for duloxetine

A

May be preferred in patients with depression requiring therapy
Take in AM with breakfast
Initial dose 20-30mg/day to final of 60mg/day
Mental fatigue improved, but general fatigue did not

12
Q

ADE’s for duloxetine

A

nausea, headache, and dry mouth

usually occurred within the first three months of therapy